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- - <br /> .;, <br /> BUILDING PERMIT INFORMATION <br /> ADDRE55 ���`� Sii/ �7 TYPE l��. �F� �� <br /> (1) BUILDING PERMIT FEE $j�,�OOC9 , � $ 0 <br /> (AJ PLAN CHECK FEE d-' <br /> (2) PIUMBING �s � � <br /> l 4� �� <br /> (3) MECHANICAL �� <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE / �(X� <br /> (A) TO BE DETERlv11NED HY BLDC INSPECiOR �� INCH <br /> (8) EXIST. WATER SERVICE, APPLICATION NO <br /> (C) APPROX. LOCATION ����-/J,d�,i,� Q p�j10X 2SFT � OG <br /> � , <br /> � Ot� .� T�c, ST. CHART U- � -7 �I-5' <br /> (5) DRIVEWAY PERMII' TO BE PAID PRIOR TO BUILDING PER1,11T IS- <br /> SUANCE FEET DRIVEWAY(TYPE) � �� �� <br /> 5 <br /> (7) STATUS OF SEWER CHnRCES: <br /> BOND DISTRIC7 FOOTAGE �/1JT�f�t//J <br /> � '+, 5. E, W <br /> NOTES <br /> ��s,o-� UT��t r� %� <br /> �,�� //7/-� 5- <br /> i�2 � � /�I o0 <br /> �j�Zl�'� �7/. o r� <br /> �S�J, v� <br /> SEWER CONNECTION CHARGES <br /> YEAr�. TRUNK • b <br /> LATERAL <br /> TOTAL CONNECTION ChiARCES 5 _ <br /> SEWER PERM[T FEE g •���<Od <br /> CATCH BASIN PERMIT FEE ��- <br /> TOTAL SEWER PERMIT FEES E �-�>0� Ca <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK $ <br /> LATERAL <br /> SEWER SERVICE <br /> APPROX. LOCATION Uf SIDF. SEWER OR TEE IN THE MAIN: _ � .�iJ.r11/J�: ,9� ���U' <br /> ZE�� 11i��S��C1K - f F7 t' D6 �/l �� / .f ✓1�t. <br /> ,� � _'/- r <br /> �� CHART ��' �5'� 29-5 <br /> INFO COMPILED BY: DATE <br /> APPROVAL: _ _ DATE <br /> s�ea <br />